LACDMH is planning for shut-down of the Prescription Authorization Tracking System (PATS) before their IBHIS implementation, no schedule as yet. So they have formed an E-Prescribing Workgroup with some contract provider and ACHSA participation.
They are contemplating the method and partner that LACDMH will use for e-prescribing. The EHR-S vendor that DMH selects for their IBHIS solution will have an e-prescribing partner already, such as SureScripts or Emdeon. But, if DMH uses a solution outside of their EHR-S they may be able to obtain FREE e-prescribing services, as the pharmacies typically pay for the user fees to incent this non-paper prescribing method.
The trade-off for LACDMH may be the integration of prescriptions with their EHR-S and the client chart, unless the custom interface can be done to also integrate with the EHR-S, which would require the EHR-S vendor's cooperation.
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A brief background on this for those of you who have no idea what I am talking about:
Medicare is pushing all prescribers to use e-prescribing, they are offering financial incentives to implement via the E-Prescribing Incentive Program, and soon dis-incentives for those who don't implement on their schedule. See details here: https://www.cms.gov/EPrescribing/
The EHR-S vendors are typically partnering with an e-prescribing software company and integrating this into their product which they offer to you. There is sometimes a set-up fee and then always a monthly or annual fee by prescriber. This usually is a link in the EHR-S medication service workflow that takes the doctor to the e-prescribing software site to write the client's prescription, where it provides the doctor with medication interaction and formulary information, and then syncs back to the EHR-S client chart to provide the client medication history from within the EHR-S (this is the important part!).
The advantage of an EHR-S integrated approach to e-prescribing is the ability to keep all reporting and compliance tracking from within the EHR-S system, giving you the ability to correlate medication data with other client and service data, and the ability to enable automation and messaging features using the medications. E.g. if the EHR-S 'knows' what meds the client is on, you may be able to develop alerts and other notifications to the treatment team versus using two separate systems where the EHR-S will not 'know' what meds the client is on to assist the providers and automate workflows, using this information.
Another example that comes to mind is the client medication authorization process. If the EHR-S has the medication data and then can manage the authorization form tracking, you can keep your compliance data and reporting all in one system. If a custom e-prescribing solution is used and not integrated with the EHR-S data, then either the custom solution must manage authorizations and QA must look their for chart audits too, or someone must enter data from the e-prescribing system into the EHR-S manually to track this all in one place, not graceful nor efficient.
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For contract providers, the impact of the IBHIS e-prescribing method will depend on the chosen solution. Here are some of my thoughts for the workgroup to consider are here:
Note: I will refer to the off-EHR-S solution as a "custom solution" and the EHR-S provided partner as the "EHR-S solution" (although all the e-prescribing interfaces are really 'custom' to the agency, they are not unique, but rather standard based on the prescribing software partner).
My two cents: if this solution can be free to providers, then it warrants further investigation by each provider for integration into their EHR-S. If it is not free, then go with your EHR-S vendors' proven solution.
They are contemplating the method and partner that LACDMH will use for e-prescribing. The EHR-S vendor that DMH selects for their IBHIS solution will have an e-prescribing partner already, such as SureScripts or Emdeon. But, if DMH uses a solution outside of their EHR-S they may be able to obtain FREE e-prescribing services, as the pharmacies typically pay for the user fees to incent this non-paper prescribing method.
The trade-off for LACDMH may be the integration of prescriptions with their EHR-S and the client chart, unless the custom interface can be done to also integrate with the EHR-S, which would require the EHR-S vendor's cooperation.
___________________
A brief background on this for those of you who have no idea what I am talking about:
Medicare is pushing all prescribers to use e-prescribing, they are offering financial incentives to implement via the E-Prescribing Incentive Program, and soon dis-incentives for those who don't implement on their schedule. See details here: https://www.cms.gov/EPrescribing/
The EHR-S vendors are typically partnering with an e-prescribing software company and integrating this into their product which they offer to you. There is sometimes a set-up fee and then always a monthly or annual fee by prescriber. This usually is a link in the EHR-S medication service workflow that takes the doctor to the e-prescribing software site to write the client's prescription, where it provides the doctor with medication interaction and formulary information, and then syncs back to the EHR-S client chart to provide the client medication history from within the EHR-S (this is the important part!).
The advantage of an EHR-S integrated approach to e-prescribing is the ability to keep all reporting and compliance tracking from within the EHR-S system, giving you the ability to correlate medication data with other client and service data, and the ability to enable automation and messaging features using the medications. E.g. if the EHR-S 'knows' what meds the client is on, you may be able to develop alerts and other notifications to the treatment team versus using two separate systems where the EHR-S will not 'know' what meds the client is on to assist the providers and automate workflows, using this information.
Another example that comes to mind is the client medication authorization process. If the EHR-S has the medication data and then can manage the authorization form tracking, you can keep your compliance data and reporting all in one system. If a custom e-prescribing solution is used and not integrated with the EHR-S data, then either the custom solution must manage authorizations and QA must look their for chart audits too, or someone must enter data from the e-prescribing system into the EHR-S manually to track this all in one place, not graceful nor efficient.
_______________________
For contract providers, the impact of the IBHIS e-prescribing method will depend on the chosen solution. Here are some of my thoughts for the workgroup to consider are here:
Note: I will refer to the off-EHR-S solution as a "custom solution" and the EHR-S provided partner as the "EHR-S solution" (although all the e-prescribing interfaces are really 'custom' to the agency, they are not unique, but rather standard based on the prescribing software partner).
- Will the LACDMH selected custom e-prescribing solution offer the same interface and service fees (free?) to each contract provider?
- Is this going to be an interface written by DMH staff and not available to contract providers too? If contract providers hire a programmer to write their own too, will they be offered free services, paid for by pharmacies?
- Will this solution allow for integration to the chart/each EHR-S? or will this solution require medication histories to be maintained outside the chart (i.e. for any EHR-S automation features, you will need to pay for service thru your EHR-S)?
- Should contract providers now wait to implement their e-prescribing solution until they know what DMH is going to do and what their partner will offer to providers? (there is sometimes a set-up fee which would be lost, but then the monthly service could be cancelled at anytime, if the contract allows for this)
- Will DMH provides some guidance and recommendations now to the providers as they are begin to incur these costs?
My two cents: if this solution can be free to providers, then it warrants further investigation by each provider for integration into their EHR-S. If it is not free, then go with your EHR-S vendors' proven solution.
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